Wellbeing Maternity Ideas Portal

I’ve just reviewed this now and also been into E3. I can see that they already have a ‘gender’ field which also has a note against it explaining that this is a patient’s current gender and not necessarily the gender they were born as.

I can’t see anywhere that you can amend this and am suspecting that this is populated from the TIE based on the sex from our PAS system (and will therefore always be female for the mum) Therefore as an interim solution until Our PAS system is updated to capture the correct information (being discussed at present) I would suggest that E3 could possibly make this field editable and can therefore be changed to male? That way, we don’t need to amend our TIE and our internal process could be that an appropriate superuser could then be responsible for updating the gender as/when the situation arises? Interestingly EuroKing don’t actually have a sex field.

Thanks Alistair, I have raised this with our PAS and integration teams and am waiting for a response. This is slightly complicated here at Frimley as we are currently in the process of changing PAS systems so it may have to go on the to do list. Thanks. Tracy

Thanks Alistair,

Option 2 looks the best for us at MTW, assuming we can get Allscripts to send the "patient preferred gender" and amend the TIE.

We are currently working towards an upgrade of our PAS system with IMS Maxims.  I am waiting for confirmation as to what changes they are planning in respect of "gender".  We would definitely be against Option 3. 

All,

 

As there have been a growing number of requests to handle the increasing variation of identification and preference of gender within both Trust PAS and Maternity System, we have the following options available which should have facilitate the transfer of male identified adult patients into the maternity system. We appreciate that this is potentially not a “one size fits all” situation given the variation of PAS systems in our customer base and how flexible the Trust Integration Engine (TIE) may be. Therefore, please read the options below and consider which may be a best fit for your Trust.

 

A general point of note

 

When considering any of the below options it’s essential to consider messaging traffic volumes and the potential impact on the Trust server architecture. Therefore, even if one of the below options seems applicable to how your PAS and EuroKing systems interact, there will be a review conducted prior to implementation to ensure there will be no degradation of operational performance. If, post review, any issues are identified then these will be discussed with the appropriate people prior to implementation.

 

 

Option 1 :: Whitelisting patients within EuroKing.

 

What does this mean?

 

A new List will be added to the Stats and Lists screen in EuroKing. In this List a system administrator is able to add a patient hospital number, or NHS Number, or potentially a combination of both, to a list which is maintained within EuroKing.

The TIE will need to be updated to send male patients to the maternity system. This is a Trust action and cannot be undertaken by Wellbeing.

Once male patients are being sent to EuroKing, upon receipt of a message, the EuroKing integration engine will check that the adult patient is male and if so, will cross check for the presence of the hospital number or NHS Number on the whitelist. If there is a match, the patient will be added/updated as required. If there is no match then the message will be reject.

 

Impact

Change to TIE to send male adult patients to EuroKing.

Increase in interface traffic and the vast majority of adult male patient messages being rejected.

 

Benefits

The system administrator will able to self-manage the flow of patients by adding to the whitelist and also being able to remove from the whitelist as required. No Wellbeing helpdesk or operational support is required.

Only requires an update to the TIE and EuroKing integration engine.

Does not require an update to the EuroKing system itself therefore no end user impact on daily operational system availability.

 

Option 2 :: Amendment to an identifier in PAS

 

What does this mean?

 

Adding a new demographic identifier such as a new title, if it’s possible to be updated on PAS, can be used to identify a change of preference in gender identification. This new title could then be sent within the message from PAS to EuroKing and the EuroKing integration engine will recognise the title and interpret that as a patient to be added/updated. The new title will also be added in EuroKing for consistency of data.

 

NOTE – Some PAS systems are capable of sending “patient preferred gender” – e.g. Allscripts. If this is an option, which would also demand changes to the TIE, then this can also be considered.

 

Impact

Change to the Trust PAS.

Change to TIE to send male adult patients to EuroKing. It’s feasible to then place all filtering on the TIE which would prevent any unnecessary increases in message traffic.

Change to EuroKing although this can be completed without any downtime and therefore no end user operational impact on system availability.

 

Benefits

Identification is managed on the PAS and does not require additional user or manual management within EuroKing.

 

Option 3 :: Send all male patients from PAS to EuroKing

 

What does this mean?

 

Altering the TIE to send all adult male patient records to EuroKing. This is almost a “worst case scenario” option in that the EuroKing database will be flooded with records that it may never need. It’s an extreme solution and whilst it will work, it presents a massive overhead in system operation interface traffic and server capacity. Note this is not a favoured option for Wellbeing and not one that we would ideally recommend, however it is mentioned here in case the Trust PAS is unable to be modified to cater for either option 1 or 2 mentioned above.

 

Impact

Change to TIE to send all male patients to EuroKing.

Change to EuroKing integration engine to accept male patients

The EuroKing database will bloat significantly under the weight of the additional patient records being added to the system, the majority of which may never be used.

Interface traffic will significantly increase between PAS and EuroKing.

Risk of operational impact on EuroKing with more patient information being constantly added and updated 24/7/365.

 

Benefits

All patient records are available in EuroKing however this is the interface equivalent of using a sledgehammer to crack a walnut and comes with significant risk to the continued operational capabilities of the maternity system.

 

Risk

Potentially could impact on best working practice regarding the presence of excessive redundant records on the maternity system.

Hi Alistair,

Thanks for the update.

The workaround that has been suggested by the helpdesk is unsuitable for Pennine as it does not comply with the patients wishes to remain Male. If we change the gender markers we could potentially breach the Equality Act 2010 and the Gender Recognition Act 2004. Our Inclusion & Engagement manager has advised the workaround is not acceptable.

If the workaround is used to get the patient onto E3 we also have the issue if any updates are made to the PAS record this will not update the E3 record. It will also stop the baby from registering onto PAS when the patient has delivered. I am also concerned about the wording on some of the letters using she/mother etc. while some patients would be accepting of this some would not be.

Our integration team can design a table at our side to get the patients number through but unfortunately this is still blocked at EK end.

Anything you could do to help get this patient through would be great. Apparently we had a patient last year I have just been made aware of but this patient was happy to stay on all systems as female so we had no issues.

Many thanks

Lorraine

Hi both - we're working on a better solution for this to make the whole process more seamless and not require any manual workarounds.

Paddy - remember your interface is different to everyone else's in that EuroKing goes and checks PAS when you press search - no other EuroKing system works like that,k so your proposal will only work for the EuroKing system at Cardiff.

We're having a further conversation internally on how we can improve this process for Trusts which use the traditional PUSH interface (i.e. messages sent from PAS to EuroKing - e.g. the system at Pennine).

I will post an update here when we've got an update.

I agree as the work around suggested by EK is not an acceptable one. We need to be able to pull the PAS record through so we do not need to change the gender.